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Urine Uric Acid

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261. Plasma metabolites and lipids associate with kidney function and kidney volume in hypertensive ADPKD patients early in the disease course. (PubMed)

q-value < 0.05. Specific significant metabolites, including pseudo-uridine, indole-3-lactate, uric acid, isothreonic acid, and creatinine, have been previously shown to accumulate in plasma and/or urine in both diabetic and cystic renal diseases with advanced renal insufficiency.This study identifies metabolic derangements in early ADPKD which may be prognostic for ADPKD disease progression.HALT Progression of Polycystic Kidney Disease (HALT PKD) Study A; Clinical

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2019 BMC Nephrology

262. Benzbromarone as a possible cause of acute kidney injury in patients with urolithiasis: Two case reports. (PubMed)

after benzbromarone administration. Ultrasound showed multiple small stones in both kidneys, and the 24-hour urine uric acid level was 3128 mg. In case 2, a 17-year-old male student presented with AKI after self-administration of 50 mg of benzbromarone. His Scr increased to 6.8 mg/dL on day 3 after benzbromarone administration. Ultrasound showed multiple stones in the left kidney.Both patients underwent renal biopsy, with findings of acute tubular interstitial nephropathy in case 1 and acute tubular

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2019 Medicine

263. High-Resistant Starch, Low-Protein Flour Intervention on Patients With Early Type 2 Diabetic Nephropathy: A Randomized Trial. (PubMed)

); however, it did not change the interleukin-6 and Tumor Necrosis Factor α (TNF-α) concentration.Twelve-week intervention with high-RS, low-protein flour improved the blood glucose and blood lipid levels, decreased the serum uric acid (UA) and urine β2-MG, and enhanced the ability to prevent antioxidative stress in patients with early DN.Copyright © 2018. Published by Elsevier Inc. (...) flour intake led to a significant reduction in fasting blood glucose, HbA1c, total cholesterol, and triglycerides levels (P < .05 for all). The changes in serum uric acid (UA) and β2-microglobulin (β2-MG) level were observed after high-RS, low-protein flour intervention (uric acid [mean ± standard deviation]: -24.7 ± 38.5 μmol/L, P = .001; β2-MG: 0.5 ± 0.9 mg/L, P = 0.018). In addition, high-RS, low-protein flour intake increased serum superoxide dismutase level by 10.1 ± 27.7 U/mL (P < .05

2019 Journal of Renal Nutrition Controlled trial quality: uncertain

264. Soft Drink Consumption During and Following Exercise in the Heat Elevates Biomarkers of Acute Kidney Injury. (PubMed)

. 5 (4) ng/dl, P < 0.04] and after correcting for urine flow rate [6 (7) (ng/dl)/(ml/min) vs. 4 (4) (ng/dl)/(ml/min), P = 0.03]. Changes in serum uric acid from preexercise were greater in the Soft Drink trial than the Water trial at postexercise ( P < 0.01) and 24 h ( P = 0.05). There were greater increases from preexercise in serum copeptin, a stable marker of vasopressin, at postexercise in the Soft Drink trial ( P < 0.02) than the Water trial. These findings indicate that consuming a soft

2019 American journal of physiology. Regulatory, integrative and comparative physiology Controlled trial quality: uncertain

265. Pharmacokinetics, Pharmacodynamics, and Tolerability of Concomitant Administration of Verinurad and Febuxostat in Healthy Male Volunteers. (PubMed)

. Twenty-three subjects were randomized and received once-daily doses of verinurad (or placebo) or febuxostat alone (days 1-7 and days 15-21), or verinurad + febuxostat on days 8-14. For combinations, subjects received verinurad 10 mg + febuxostat 40 mg or verinurad 2.5 mg + febuxostat 80 mg. Plasma/serum and urine samples were analyzed for verinurad, febuxostat, and uric acid. Safety was assessed by adverse events and laboratory tests. Febuxostat 40 mg had no effect on plasma exposure of verinurad 10 (...) Pharmacokinetics, Pharmacodynamics, and Tolerability of Concomitant Administration of Verinurad and Febuxostat in Healthy Male Volunteers. Verinurad (RDEA3170) is a selective uric acid reabsorption inhibitor in development for treatment of gout and asymptomatic hyperuricemia. This phase 1, single-blind, multiple-dose, drug-drug interaction study evaluated the pharmacokinetics (PK), pharmacodynamics, and safety/tolerability of verinurad in combination with febuxostat in healthy male volunteers

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2019 Clinical pharmacology in drug development Controlled trial quality: uncertain

266. Evaluation of the chemical composition of nephrolithiasis using dual-energy CT in Southern Chinese gout patients. (PubMed)

Evaluation of the chemical composition of nephrolithiasis using dual-energy CT in Southern Chinese gout patients. A study to evaluate the prevalence of uric acid (UA) nephrolithiasis with dual-energy CT (DECT) and explore the risk factors for kidney stones in primary gout patients.Eighty-four consecutive gout patients underwent urinary tract ultrasonography or DECT to confirm the existence of kidney stones. Urine and blood samples were also taken for laboratory analysis.Forty-one subjects (48.8 (...) %) patients presented hypomagnesuria. Forty-three (51.8%) patients had low urine volume. Unduly acidic urine (UAU) was present in 36 patients (44.4%). Hyperuricosuria was only found in ten (12.2%) patients. In comparison to the non-lithiasic group, the lithiasic group was more likely to have a UAU. Binary logistic regression showed that female gender was a protective factor, while disease duration of gout and low urine pH were risk factors for nephrolithiasis.Our results indicated that nephrolithiasis

2019 BMC Nephrology

267. Topiloric/Uriadec (topiroxostat)

for the indications and dosage and administration as shown below. [Indication] Gout, hyperuricaemia [Dosage and administration] The usual adult initial dosage is 20 mg/dose of topiroxostat orally administered twice daily in the morning and evening. Thereafter, the dose should be gradually increased, as needed, while monitoring blood uric acid levels. The usual maintenance dosage should be 60 mg/dose twice daily. The dose may be adjusted according to the patient’s condition, up to 80 mg/dose twice daily. 4 Review (...) of topiroxostat orally administered twice daily in the morning and evening. Thereafter, the dosage should be gradually increased, as needed, while monitoring blood uric acid levels. The usual maintenance dosage should be 60 mg/dose twice daily. The dose may be adjusted according to the patient’s condition, up to 80 mg/dose twice daily. II. Summary of the Submitted Data and Outline of Review by the Pharmaceuticals and Medical Devices Agency (PMDA) A summary of the submitted data and an outline of the review

2013 Pharmaceuticals and Medical Devices Agency, Japan

268. Acofide (acotiamide hydrochloride hydrate)

burning; and there is no evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms.” The cause of FD is not fully elucidated. The current assumption is that the symptoms are caused by the involvement of multiple factors including abnormal gastric emptying, gastric dysrhythmia, gastric hypersensitivity, hypersensitivity and motility disorder of the small intestine, impaired postprandial relaxation of the gastric fundus, vagus nerve disorder, enhanced acid (...) by elementary analysis, ultraviolet spectroscopy, infrared spectrophotometry (IR), water content, hydrochloric acid content, nuclear magnetic resonance spectrometry ( 1 H-, 13 C-NMR), mass spectrometry, and X-ray crystallography. 2.A.(1).2) Manufacturing process The drug substance is manufactured using ***************************************, ********************************, and ***************************** as the starting materials through ** **** processes and ** **** processes. The processes

2013 Pharmaceuticals and Medical Devices Agency, Japan

269. Jeffrey Aronson: When I use a word . . . Discovering lithium

, and so Cade thought that bipolar affective disorder, as we now call it, might be due to some abnormal endogenous substance. He found that urine from affected patients was more toxic than urine from controls when injected into guinea pigs, who died from urea toxicity. Because the urinary urea concentrations were the same in the two groups, Cade thought that something else in the patients’ urine enhanced urea toxicity. Choosing uric acid as a candidate he investigated the effects of a combination (...) by . In 1843 the Scottish physician and chemist Alexander Ure (1778–1857) used lithium carbonate to dissolve , and lithium salts were also used to treat gout and other diseases, such as epilepsy, migraine, rheumatism, eczema, diabetes mellitus, Bright’s disease, and gallstones, all thought to be related to a “uric acid diathesis”. Lithium chloride was used as a salt substitute in the US, under brand names such as Foodsal, Milosal, Salti Salt, and Westsal; cases of led to the withdrawal of all such products

2017 The BMJ Blog

270. Prevention of Recurrent Kidney Stones

with residual or recurrent struvite stones in whom surgical options have been exhausted, AUA cites acetohydroxamic acid as a treatment option. AUA recommends potassium citrate for patients with uric acid and cystine stones in order to raise urinary pH to an optimal level. Prevention of Recurrent Kidney Stones ACP (2014) Recommendation 1 : The ACP recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis. ( Grade (...) animal protein. ( Expert Opinion ) Clinicians should counsel patients with uric acid stones or calcium stones and relatively high urinary uric acid to limit intake of non-dairy animal protein. ( Expert Opinion ) Clinicians should counsel patients with cystine stones to limit sodium and protein intake. ( Expert Opinion ) Pharmacologic Therapies Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. ( Standard; Evidence Strength

2015 National Guideline Clearinghouse (partial archive)

272. Venetoclax (Venclyxto) - Chronic, B-Cell Lymphocytic Leukemia

lysis syndrome CYP cytochrome P DNA deoxyribonucleic acid DOR duration of overall response DSC Differential Scanning Calorimetry ECCr estimated creatinine clearance rate using Cockcroft Gault formula ECG electrocardiogram ECOG Eastern Cooperative Oncology Group Ecrf electronic case report form EFS event free survival EORTC European Organization for Research and Treatment of Cancer EQ VAS European Quality of Life -Visual Analogue Scale EQ-5D-5L European Quality of Life 5 Dimensions 5 Levels (...) survival PG pharmacogenetics Ph. Eur. European Pharmacopoeia PK pharmacokinetic(s) PLM Polarised light microscopy PP Polypropylene PR partial remission PT prothrombin time PVC Poly vinyl chloride QbD Quality by design QC Quality Control QLQ C30 Quality of Life Questionnaire Core 30 QLQ CLL16 Quality of Life Questionnaire Chronic Lymphocytic Leukaemia 16 QoL quality of life QWP Quality Working Party RH Relative Humidity RNA ribonucleic acid RPTD the recommended Phase 2 dose RRT Relative retention time

2017 European Medicines Agency - EPARs

273. Urolithiasis

characteristics may provide information on the type of stone. Oral chemolitholysis is based on alkalinisation of urine by application of alkaline citrate or sodium bicarbonate [78, 80]. The pH should be adjusted to 7.0-7,2. Within this range, chemolysis is more effective at a higher pH, which might lead to calcium phosphate stone formation. Monitoring of radiolucent stones during therapy is the domain of US, however, repeat NCCT might be necessary. In the case of uric acid obstruction of the collecting system (...) related to calcium stones 44 4.6.1 Hyperparathyroidism 44 4.6.2 Granulomatous diseases 45 4.6.3 Primary hyperoxaluria 45 4.6.4 Enteric hyperoxaluria 45 4.6.5 Renal tubular acidosis 45 4.6.6 Nephrocalcinosis 47 Diagnosis 47 4.7 Uric acid and ammonium urate stones 47 4.7.1 Diagnosis 47 4.7.2 Interpretation of results 47 4.7.3 Specific treatment 48 4.8 Struvite and infection stones 48 4.8.1 Diagnosis 48 4.8.2 Specific treatment 49 4.8.3 Recommendations for therapeutic measures of infection stones

2015 European Association of Urology

274. Paediatric Urology

Subureteric injection of bulking materials 47 3M.3.2.2 Open surgical techniques 48 3M.3.2.3 Laparoscopy 48 3M.3.3 Recommendations for the management of vesicoureteric reflux in childhood 49 3N URINARY STONE DISEASE 51 3N.1 Epidemiology, aetiology and pathophysiology 51 3N.2 Classification systems 51 3N.2.1 Calcium stones 51 3N.2.2 Uric acid stones 52 3N.2.3 Cystine stones 53 3N.2.4 Infection stones (struvite stones) 53 3N.3 Diagnostic evaluation 53 3N.3.1 Imaging 55 3N.3.2 Metabolic evaluation 55 3N.4 (...) Recommendations for the treatment of acute scrotum in children 15 3E HYPOSPADIAS 15 3E.1 Epidemiology, aetiology and pathophysiology 15 3E.1.1 Risk factors 15 3E.2 Classification systems 15 3E.3 Diagnostic evaluation 16 3E.4 Disease management 16 3E.4.1 Age at surgery 16 3E.4.2 Penile curvature 17 3E.4.3 Preservation of the well-vascularised urethral plate 17 3E.4.4 Re-do hypospadias repairs 17 3E.4.5 Urethral reconstruction 18 3E.4.6 Urine drainage and wound dressing 18 3E.4.7 Outcome 18 3E.5 Follow-up 19 3E

2015 European Association of Urology

275. Modification of lifestyle and nutrition interventions for management of early chronic kidney disease

therapy. Once blood pressure is controlled, low-dose acetylsalicylic acid therapy should be considered. _______________________________________________________________________________________________________________________ Early Chronic Kidney Disease July 2012 Page 20 of 50 SUGGESTIONS FOR FUTURE RESEARCH 1. An RCT of different levels of fluid intake ( 3L/day) on CKD progression in patients with stage 1-3 CKD. 2. A study of the impact of moderation of alcohol intake on CKD progression in patients (...) . Conservative treatment with ketoacid and amino acid supplemented low-protein diets in chronic renal failure. American Journal of Clinical Nutrition. 1980; 33: 1667-72. 24. Maschio G, Oldrizzi L, Tessitore N et al. Effects of dietary protein and phosphorus restriction on the progression of early renal failure. Kidney International. 1982; 22: 371-6. 25. Maschio G, Oldrizzi L, Tessitore N et al. Early dietary protein and phosphorus restriction is effective in delaying progression of chronic renal failure

2013 KHA-CARI Guidelines

276. KHA-CARI Guideline: Early chronic kidney disease: Detection, prevention and management

-platelet therapy Guideline recommendations a. We suggest that aspirin therapy should not be routinely recommended as the risk : bene?t for primary prevention of CVDinpatientswithearly(stage1–3)CKDisuncertain(2C). 17. Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: uric acid-lowering agents Guideline recommendations a. We suggest that use of uric acid lowering agents (such as allopurinol, rasburicase or feboxostat) should not be rou- tinely recommended in people (...) . Hyperuricaemia – where nephrology meets rheumatology. Rheumatology 2008; 47 (7): 960–64. 41. Badve SV, Brown F, Hawley CM et al. Challenges of conducting a trial of uric-acid-lowering therapy in CKD. Nat. Rev. Nephrol. 2011; 7 (5): 295–300. 42. Sturm G, Kollerits B, Neyer U, Ritz E, Kronenberg F. Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? The Mild to Moderate Kidney Disease (MMKD) Study. Exp. Gerontol. 2008; 43: 347–52. 43. Ravani P, Malberti F, Tripepi G et al

2013 KHA-CARI Guidelines

277. Risk factors for early chronic kidney disease

combined haematuria and proteinuria and 3% had elevated serum creatinine levels (=100 µmol/l in women and =115 µmol/l in men). A subsequent cross-sectional study of 129 patients with rheumatoid arthritis observed that the prevalence of stages, 1, 2, 3, 4 and 5 CKD were 11%, 20%, 15%, 0% and 0%, respectively [160]. These estimates may be inaccurate because the presence or absence of proteinuria was based on a single urine sample. Cancer Patients with malignancy can develop CKD via a variety (...) Epidemiologici in Nefrologia (GISEN). Ramipril Efficacy in Nephropathy. Lancet. 1998; 352: 1252-6. 66. Newman DJ, Mattock MB, Dawnay ABS et al. Systematic review on urine albumin testing for early detection of diabetic complications. Health Technology Assessment (Winchester, England). 2005; 9: iii-vi. 67. Orchard TJ, Dorman JS, Maser RE et al. Prevalence of complications in IDDM by sex and duration. Pittsburgh Epidemiology of Diabetes Complications Study II. Diabetes. 1990; 39: 1116-24. 68. Parving HH

2013 KHA-CARI Guidelines

278. Clinical Practice guideline on the diagnosis and treatment of hyponatraemia

excretion, fractional urea excretion and plasma copeptin concentration [103, 107, 108, 110]. Overall, fractional excretion of uric acid using a threshold of >12% seemed most useful for distinguishing hyponatraemia due to SIAD from non-SIAD hyponatrae- mia in patients under diuretics with a sensitivity of 0.86 and speci?city of 1.0. In comparison with urine sodium concentration, fractional uric acid excretion may be a better test for differentiating hyponatraemia in patients who are also treated (...) sensitivity and acceptable speci?city in distinguishing hypovolaemia from euvolaemia or hyper- volaemia [89, 103, 107, 108]. This means that a urine sodium concentration=30 mmol/l suggests low effective arterialbloodvolume,eveninpatientsondiuretics. Diagnosticdif?cultywithdiuretics We suggest interpreting urine sodium concentrations >30 mmol/l with caution if patients are taking diuretics. In patients using diuretics, a fractional excretion of uric acid 100 mOsm/kg, urine sodium concentration =30 mmol/l

2014 European Renal Best Practice

279. Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents

with increased ambulatory BP. , Other proposed determinants of ambulatory BP include autonomic tone, adiponectin, , and serum uric acid. Lower plasma renin activity was independently associated with lower 24-hour SBP in obese adolescents. However, blood aldosterone-to-renin ratio was not found to be associated with ambulatory BP in healthy children, although it did correlate with LVM. Finally, elevation of several ambulatory BP parameters has been associated with stimulant use in pediatric patients (...) with prehypertension, including LVM values similar to youths with sustained hypertension, lower glomerular filtration rate, and increased urine protein excretion, as well as higher cIMT than normotensive patients. Patients with prehypertension may also be at higher risk of progressing to sustained hypertension. Although no longitudinal ABPM studies have been performed to evaluate the risk of progression of prehypertension, such studies could clarify the importance of prehypertension by providing more careful

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2014 American Heart Association

280. Guidelines for Hospital Discharge of the Breastfeeding Term Newborn and Mother: The Going Home Protocol,

have been performed during the hospitalization, preferably at least once every 8–12 hours. In countries such as Japan, where the hospital stay may last up to a week, assessment should continue until breastfeeding is successfully established and then may decrease in frequency. These should include evaluation of posi- tioning, latch, milk transfer, clinical jaundice, stool color and transition, stool and urine output, and nota- tion of uric acid crystals if present. Infant’s weight and percentage (...) not to overload mothers. Speci?c information should be provided in written form to all parents regarding: a. prevention and management of engorgement b. interpretation of infant cues and feeding ‘‘on cue’’ c. indicators of adequate intake (evacuation of all meconium stools, three to four stools per day by Day 4, transitioning to yellow bowel movements by Day 5, at least ?ve to six urinations per day by Day 5, and regaining birth weight by Day 10–14 at the latest) d. signs of excessive jaundice 4,28 (III) e

2014 Academy of Breastfeeding Medicine

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